Adults

Typically, one tablet once daily. The dose can be adjusted based on blood pressure response.

Elderly

No special dosage adjustment is generally required, but caution should be exercised and a lower starting dose may be considered.

Renal_impairment

No dosage adjustment is usually necessary for mild to moderate renal impairment. For severe impairment, close monitoring is advised.

Onset

Amlodipine's hypotensive effect is gradual, peaking in 6-12 hours. Telmisartan's effect is evident within 3 hours.

Excretion

Telmisartan is almost exclusively excreted in feces (97%) as unchanged drug and its conjugate. Amlodipine is primarily excreted in urine (60%) as inactive metabolites, with about 10% excreted as unchanged drug.

Half life

Telmisartan has a prolonged elimination half-life of approximately 24 hours. Amlodipine has a terminal elimination half-life of 30-50 hours.

Absorption

Telmisartan is rapidly absorbed, with bioavailability varying by dose. Amlodipine is slowly and well absorbed from the gastrointestinal tract; its bioavailability is approximately 60-65%.

Metabolism

Telmisartan is metabolized by conjugation to form a pharmacologically inactive acylglucuronide. Amlodipine is extensively metabolized in the liver to inactive metabolites.

NSAIDs

Concomitant use with NSAIDs may reduce the antihypertensive effect of Telmisartan and increase the risk of renal impairment.

Lithium

Increases in serum lithium concentrations and lithium toxicity have been reported with concomitant use of ARBs. Monitor lithium levels.

CYP3A4 Inhibitors

Strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole) may increase Amlodipine exposure, leading to increased risk of hypotension.